Individual
GARY D HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LMFT
Contact information
Practice address
12970 W BLUEMOUND RD, SUITE 105, ELM GROVE, WI 53122-2607
(262) 787-2904
(262) 787-2909
Mailing address
62 E ROSSMAN ST, HARTFORD, WI 53027-1237
(262) 673-3522
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2027-123
WI
106H00000X
Marriage & Family Therapist
Primary
339-124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40955300
—
WI
Enumeration date
12/26/2006
Last updated
09/11/2025
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